Evaluating students' use of web-based communication during practice placements.
Abstract: Web-based technologies are being used increasingly for communication and education within occupational therapy curricula, including practice placement modules. The purpose of this study was to incorporate and evaluate web-based communication during practice placement.

Method: Students were encouraged to use asynchronous web-based communication and were followed through three of five practice placements. A policy Delphi technique was used to gather feedback from the students about their use of this technology during practice placement.

Results: The students were divided in terms of their use of and satisfaction with web-based technologies.

Conclusion: Considerations and suggestions are made regarding the use of these technologies during practice placement for education, communication and fostering communities of practice.

Key words:

Web-based communication, education, practice placement, community of practice.
Article Type: Report
Subject: Educational technology (Usage)
Education, Higher (Curricula)
Occupational therapy (Study and teaching)
Authors: Derdall, Michele
Mulholland, Susan
Brown, Cary
Pub Date: 10/01/2010
Publication: Name: British Journal of Occupational Therapy Publisher: College of Occupational Therapists Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 College of Occupational Therapists Ltd. ISSN: 0308-0226
Issue: Date: Oct, 2010 Source Volume: 73 Source Issue: 10
Topic: Computer Subject: Technology in education
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 240098081
Full Text: Introduction and background

During the past decade, the department of occupational therapy at a Canadian university has been increasing the use of web-based technologies for education and communication within the curriculum. All modules, including practice placement modules, now have the option of incorporating a web-based learning management system (such as WebCT Vista v3 and v4/Blackboard Inc.) to provide module material and resources or to facilitate communication.

A number of studies have looked at the various forms of web-based communication used by occupational therapy students while on practice placement. Creel (2001, p56) introduced the use of chat rooms for students while on level II practice placements to 'enrich communication' between the sites, the academic practice placement coordinator and the students, and among the students themselves. Storr and Thomas (2001) discussed the use of web-based teaching tools to link their students while they were on placement, in order to promote the exchange of knowledge and experiences between students in their different settings. Thomas and Storr (2005) later found that student participation in web-based communication during practice placement appeared to have a positive effect on learning, on improving autonomy during the placement, in supporting self-directed learning and in stimulating higher-order thinking. A study by Wooster (2004) at the University of South Alabama noted that students embarking on a practice placement often experienced anxiety around role transitions, separation from peers and isolation. The university set up a voluntary asynchronous web-based resource, whereby students on placement were able to communicate with each other. Wooster (2004) concluded that web-based communication provided students with additional information, strategies for intervention, support and encouragement.

The two academic practice placement coordinators at this Canadian university similarly decided to incorporate web-based communication formally into practice placements and to evaluate its effectiveness. It was anticipated that there could be pedagogical advantages, such as facilitating peer support, learning and problem solving, and increasing student reflection and depth of learning. Secondly, there was the consideration of emerging trends in online health-related professional communities, such as those recently described by White et al (2008). The concept of communities of practice is defined by Wenger et al (2002, p7) as 'groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in this area by interacting on an ongoing basis'. Encouraging web-based discussion while on placement therefore seemed a logical choice for grooming students to use this 'online community' of their peers, thereby moving them towards professional communities of practice upon graduation.

Implementation of web-based discussion

During the fall of 2006, each practice placement module was set up with a web-based asynchronous discussion component using WebCT Vista v4/Blackboard Inc. The site was secure because only students who were registered in the module and the module instructors had access to the site. The discussion site was divided into two main sections. The first section, Placement Bulletin Board, contained subheadings divided into typical areas of practice, such as acute care, rehabilitation and mental health. This section was to be used by students while on placement to foster discussion with classmates in similar settings and/or with similar caseloads. The second section, Student Lounge, contained subheadings relating to accommodation, transportation, placement planning and some specific geographical placement areas. The students were encouraged to use the site to communicate with each other prior to placement (for example, to be strategic about placement selection or in sharing travel and accommodation).

The student postings were monitored randomly during the course of the placement, but all messages were read by both academic practice placement coordinators by the end of the placement. Although it was never required, the academic practice placement coordinators would have been able to delete comments from the website if they were deemed to jeopardise confidentiality. Since the intention was to determine how the students used the website, the academic practice placement coordinators did not interject comments that would influence the student discussion.

Method

The purpose of this study was to incorporate web-based communication during practice placement and simultaneously to evaluate it. The outcomes from the study could then help to inform the academic practice placement coordinators as to the benefits of this technology and if and how it should be continued.

Ethics approval was received by the University of Alberta Health Research Ethics Board prior to the commencement of the study. The sample of convenience consisted of the occupational therapy students entering the BScOT course in 2006, as all 90 students were invited to participate in the study. The study followed these students during practice placements from October 2006 to June 2008 through the 2-year course in order to provide a longitudinal perspective.

The following information was provided in written form to students in the practice placement modules prior to their first practice placement:

1. The use of WebCT for practice placement education is purely voluntary and has no bearing on practice placement grades

2. Students' comments will be read and monitored by the academic practice placement coordinators

3. If any inappropriate comments are made on WebCT, the student will be contacted by the academic practice placement coordinators

4. Personal identifiers for people and sites will be removed from the discussion content prior to data collection and analysis and, therefore, will not be in any subsequent publication.

The participants' use of the WebCT discussion was considered as consent to participate. Supervising clinicians were responsible for assigning grades in practice placement education and did not have access to the WebCT discussion.

A policy Delphi technique was used throughout this study (Willams and Webb 1994, Hasson et al 2000). This approach collects questionnaire information from participants and feeds it back to them in the form of a report. The report forms the basis of the next round of questions and allows participants to access and reflect upon other people's opinions and thoughts as they complete subsequent rounds of questionnaires. This study involved an initial analysis of student web-based discussion and the use of two subsequent Delphi rounds of student questionnaires for feedback.

Analysis of web-based discussion

At the completion of the students' first 4-week practice placement module, the web-based discussions were reviewed and analysed independently by the two academic practice placement coordinators. Seventy out of a possible 90 students (77%) posted at least once during the practice placement. Themes within both the Placement Bulletin Board and the Student Lounge sections were identified. These themes formed the headings for the first Delphi questionnaire, which was presented to the students in a hard copy format when they were back at the university doing academic module work.

Results

Fifty-nine students (66% of the class) completed the first questionnaire based on the above analysis, where they ranked the most and least important themes from the Placement Bulletin Board. Some students did not complete all the questions and therefore the total responses do not equal 59. The results were analysed by a research assistant and are presented in Table 1.

The participants then ranked the importance of themes from the Student Lounge section. These were similarly analysed by a research assistant and are presented in Table 2.

Many students provided additional positive comments relating to the use and importance of web-based discussion, which reiterated the original themes. There was also an appreciation of being able to brainstorm, problem solve, clarify and collaborate with peers around practice placement issues as well as around academic assignments. The students confirmed that web-based discussion was an important mechanism for providing peer support, emotional sharing, venting, getting advice, validating and connecting. It was a useful tool to arrange accommodation and transportation and some felt that it was simply interesting and enjoyable to share experiences.

Certain students also provided critical comments relating to their reasons for not using web-based discussion or being reluctant to use it. They felt that issues were not important enough to comment on, were not a priority or that this same information could be accessed by other means. Some students noted the difficulty in having good computer or internet access as well as the time and energy expended to be able to access this web communication. Others preferred to express feelings or discuss issues with people other than classmates (family, friends and preceptors) or to use other means for communicating. Some preferred to work things out on their own or to self-reflect. Interestingly, some found that the discussion, particularly around assignments, created more confusion, anxiety or misinterpretation. A few students also commented on the lack of clarity as to whether the web postings were mandatory or not.

The results from the first Delphi questionnaire were provided to the students as a report. Twenty-two students completed a second Delphi questionnaire based on this report, which asked their opinions on the usefulness of web-based discussion. There seemed to be a split between those who appreciated this tool and who liked to use it and those who did not. For those with positive comments, it was felt to be an easy and effective way to connect with their classmates and share information. For those who did not use it or did not like using it, the reasons again emphasised the time and the access restraints. They also preferred other means of communication, such as using the phone, using resources at their practice placement site or using other web-based technology to access their own groups, such as Facebook or Discuz.

Discussion

The rationale for introducing a web-based discussion tool during practice placements was to increase students' communication with each other for various practical and learning purposes. It was anticipated that online discussion in this context could also initiate students to the concept of professional communities of practice, which they might be a part of in future practice.

For those who liked and used the technology, it seemed that they did, in fact, achieve some of the pedagogical intentions of using the web-based communication, such as access to peers to collaborate, brainstorm, problem solve and clarify issues relating to practice placements. They also identified the importance of peer support, for emotional sharing, venting, advice, validation and connecting. All of these elements align with some of the premises put forward by Wenger's concept of communities of practice, where the purpose is said to 'develop members' capabilities; to build and exchange knowledge' (2000, p142). Wenger (2000) went on to note that what holds a community of practice together should be 'passion, commitment, and identification with the group's expertise' (p142), which could also be seen in some of the students' comments about the value of connecting with each other.

Then there were those students who saw using the module's web-based communication as added work or as not useful or who preferred other forms of communication. Some reasons for not using the technology were purely practical and related to ease of access and time constraints. One problem with initiating web-based communication in the context of a module is the expectation for all students to participate. Some students indicated that they preferred to find their own groups and methods of communication, which aligns with a functional community of practice where Wenger (2000) noted that members should select themselves. Another issue has to do with how quickly technology changes and how perceived usefulness depends on other available technology at the time. Many students might identify other forms of communication as being more valuable or accessible; for example, the use of text messaging or other online technology, such as weblogs, chat rooms, Facebook or the like.

The limitations of the study include the attrition of participants with each successive round of the Delphi and the resultant small number of students answering the final questionnaire. Another limitation was in how the students were initially asked to participate in the discussion. Although the initial written information clearly indicated that the use of the discussion was voluntary, students were also encouraged to participate. This may have given mixed messages to the students. Some students may have posted to the discussion because of a perceived requirement rather than for any inherent value of communicating with peers.

Conclusion

Using a web-based discussion tool for students on practice placement has merit for learning, planning and peer support. An advantage of a university-based tool is that it is a secure and monitored environment, which provides a level of confidentiality and protection for both students and clients. However, there are a number of factors to consider that could make the experience more positive and useful. If it is intended to be a communication tool for the planning and exchange of information pertaining to a particular module, clear expectations need to be set and the tool needs to be accessible and easy to use. If it is intended to begin to foster the concept of communities of practice for the students, instructors need to be more aware of how to facilitate and cultivate this process without imposing it (Wenger et al 2002). If a purpose is to encourage students to communicate with each other for pedagogical and support-oriented reasons, instructors need to facilitate this by using the best technology available at the time. Just as importantly, they need to ensure that students are using it effectively, safely and ethically.

Acknowledgements

Our warm thanks to the students at the University of Alberta who piloted use of this technology during their practice placements and who subsequently took the time to provide feedback. Thank you also to Douglas MacNeill for data entry.

Conflict of interest: None.

Key findings

* Web-based discussion for students during practice placement has merit for learning, planning and peer support.

* Faculty should set clear expectations, facilitate rather than impose technology use and ensure that the technology is current and user friendly.

What the study has added

This study adds another student perspective on the use of university-facilitated web-based communication during practice placement, particularly how students used the technology and why they liked or did not like using it.

References

Creel AT (2001) Chat rooms and level II practice placement. Occupational Therapy in Health Care, 14(2), 55-59.

Hasson F, Keeney S, McKenna H (2000) Research guidelines for the Delphi survey technique. Journal of Advanced Nursing, 32(4), 1008-15.

Storr C, Thomas A (2001) New techno-teaching tools: do they have a place in clinical education? Occupational Therapy Now, 3(2). Available at: http://www.caot.ca/otnow/march01-eng/march01-techno.cfm Accessed on 28.10.08.

Thomas A, Storr C (2005) WebCT in occupational therapy clinical education: implementing and evaluating a tool for peer learning and interaction. Occupational Therapy International, 12(3), 162-79.

Wenger E, Snyder W (2000) Communities of practice: the organisational frontier. Harvard Business Review, Jan-Feb, 139-45.

Wenger E, McDermott RA, Snyder W (2002) Cultivating communities of practice: a guide to managing knowledge. Boston: Harvard Business School Press.

White C, Basiletti M, Carswell A, Head B, Lin L (2008) Online communities of practice: enhancing scholarly practice using web-based technology. Occupational Therapy Now, 10(5), 6-7.

Williams PL, Webb C (1994) The Delphi technique: a methodological discussion. Journal of Advanced Nursing, 19(1), 180-86.

Wooster D (2004) An exploratory study of web-based supports for occupational therapy students during level II practice placement. Occupational Therapy in Health Care, 18(1-2), 21-29.

Michele Derdall, (1) Susan Mulholland (2) and Cary Brown (3)

(1) Formerly Academic Coordinator of Clinical Education (Sask.), Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada.

(2) Formerly Academic Coordinator of Clinical Education, and now Adjunct Associate Professor, Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada.

(3) Associate Professor, Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada.

Corresponding author: Michele Derdall, Box 123, Outlook, Saskatchewan, Canada. Email: michele.derdall@sasktel.net

Reference: Derdall M, Mulholland S, Brown C (2010) Evaluating students' use of web-based communication during practice placements. British Journal of Occupational Therapy, 73(10), 457-460.

DOI: 10.4276/030802210X12865330218221

[C] The College of Occupational Therapists Ltd. Submitted: 22 December 2008. Accepted: 3 September 2010.
Table 1 Placement Bulletin Board themes

Themes                                         Most        Least
                                            important    important
                                              n (%)        n (%)
Case/client-specific themes (for
example, problem solving, questions,
answers and feedback)                       38 (66.7)     7 (12.3)

Description and comparisons of
placements (for example, setting,           30 (52.6)    17 (29.8)
clients and pace)

Sharing the 'personal' (for example,
excitement, enjoyment, fatigue,
frustrations, placement disappointments     28 (49.1)    19 (33.3)
and peer support)

Discussion regarding academic
assignments (that they were responsible
for while on placement)                     22 (38.6)    12 (21.1)

Discussion regarding the challenges of
the placement (for example, the health
system, ethics, death and dying, and        17 (29.8)    25 (43.9)
funding issues)

Comparing and integrating school/ideals
with reality (for example,
client-centredness, working in
interprofessional teams, doing               9 (15.8)    28 (49.1)
assessments and charting)

Description of student opportunities
(for example, team and family
communication, diversity of practice,
personal development and understanding
the role of occupational therapists)         8 (14.0)    29 (50.9)

Table 2 Student Lounge themes
Themes                                        Most        Least
                                           important    important
                                             n (%)        n (%)

Background information on site             27 (47.4)     7 (12.3)
(question and answer)

Where is your placement? (finding out      24 (42.1)    14 (26.6)
where everyone is going)

Connecting (getting together before        19 (33.3)    21 (368.)
and during placement)

Accommodation (sharing information         19 (33.3)    20 (35.1)
regarding more distant locations)

General questions and answers              15 (26.3)    20 (35.1)
(reference letter, gift for
supervisor and conference)

Transportation (parking and carpool)       10 (17.5)    28 (49.1)
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